Schizophrenia refers to a brain disorder that normally alters the manner in which an individual thinks, acts, or perceives the surrounding and the world in general. Persons affected by the syndrome usually have a different or altered perception of the reality; they sometimes even lose contact with the reality completely. Schizophrenic patients may hear or see imaginary things that ideally do not exist, speak or exchange words in a manner that is strange and confusing, have a constant fear that the people surrounding them will harm or destroy them, or they have a constant feeling that they are being monitored each and every time. These patients tend to withdraw from the general public due to constant fear (Help Guide, n.d.).
The onset of schizophrenia is mainly during early adulthood or late teens. However, the condition is capable of occurring at any stage in one’s life. Rarely does the disease affect young children and adolescents; even if it does affect them, the signs and symptoms are different. The severity of the condition is dependent on the time of onset; the disease is more sever if it has an earlier onset. It also appears to be more severe in men compared to women (Help Guide, n.d.). This essays aims at discussing this disease condition in detail, including its etiology, signs and symptoms, treatment strategies and the treatment goals, and the impact the disease has on an individual life.
The actual cause of schizophrenia is not well known. However, the condition is said to result from a combination of various factors, particularly genetic factors, environmental factors, and abnormalities within the brain (Help Guide, n.d.).
Schizophrenia is highly associated with a hereditary component, where individuals whose siblings or parents are affected by the condition have a 10% probability of developing the disease in their lifetime, as opposed to the 1% probability in the general population. It should be noted, however, that the condition is only influenced by genetics, but not determined by the same genetics. For instance, though the disease is known to run in families, approximately 60% of persons with the syndrome have family members who never suffered the syndrome. More so, persons who are always predisposed to the condition do not acquire the disease in the long run (Help Guide, n.d.).
Studies have suggested that the genetic composition of an individual increases the vulnerability of contracting the disease. The environmental factors, on the other hand, act upon this vulnerability, thereby increasing factors that trigger the disorder. Stress at any stage of development, including pregnancy, has been identified as the major environmental factor contributing to the onset of the condition.
Stress triggers the onset of schizophrenia by elevating the levels of the hormone cortisol within the body. The environmental factors that are known to cause stress are, therefore, potential triggers of schizophrenia. These factors include sexual or physical abuse during childhood, early parental separation or loss, low levels of oxygen during parturition and exposure to a viral infection either prenatally or during infancy (Help Guide, n.d.)
Schizophrenia is linked with altered brain chemistry and brain structure abnormality. Such alterations evident in these patients include enlarged brain ventricles and reduced activity of the frontal lobe. Evidence is, however, lacking to confirm that the condition occurs due to a particular alteration within the brain (Help Guide, n.d.).
Pathophysiology and Disease Progression
Though the condition may occur suddenly in some individuals, it normally has a slow onset. The condition begins with early warning signs, coupled with a decrease in the functionality of the affected person. During this phase, the affected individual usually appears unmotivated, eccentric, reclusive, and emotionless. The victims tend to isolate themselves from the rest, say or talk about imaginary things, neglect their own appearance, and generally develop a different form of lifestyle that is not normal. They leave what they like doing most, with reduced performance either at school or workplace (Help Guide, n.d.)
The most common warning signs that appear early in a victim include suspiciousness or hostility, social withdrawal, persistent depression, insomnia or oversleeping, loss of ability to express feelings such as joy or sadness, weakening of personal hygiene, poor concentration, forgetfulness, irrational or odd statements, uttering of strange words, and overreacting to criticism. Though these signs can occur in other disease conditions, they are very helpful in providing a hint about the probable onset of schizophrenia. Whenever identified, the affected victim should seek medical attention immediately (Help Guide, n.d.).
Signs and Symptoms
Schizophrenic symptoms vary greatly among different victims in terms of their severity and pattern. However, there are five major symptoms that characterize this condition. They include hallucinations, delusion, weird behavior, disorganized speech, and the “negative symptoms”.
Hallucinations refer to imaginary sensations or sounds that are perceived as real, yet they only occur within the individual’s mind. Though hallucinations can affect all the five senses of the body, auditory hallucinations are the most common, followed by visual hallucinations. Research has suggested that auditory hallucination occurs when one interprets self-talk as if they are coming from an external source. In the mind of the victim, the voices are always vulgar, abusive, or critical. It worsens when the victim is lonely (Help Guide, n.d.).
This refers to a situation where the victim holds a certain idea firmly, insisting it is true, yet there is obvious or clear evidence proving the contrary. It is a very common sign, appearing in approximately 90% of all schizophrenic patients. Common examples of delusions include:
- Delusion of reference: Refers to a state where a natural and harmless environment is perceived by the victim to be special and directed to the victim.
- Delusion of persecution: A state where the victim always believes that others, whether imaginary or real, are always on a mission to finish them.
- Delusions of grandeur: A situation where the victim believes they are the most important or possesses some extraordinary powers that no one else can have.
- Delusion of Control: In this state, the victim feels all their thoughts are never independent, but they are always controlled or micro-managed by an external force.
Schizophrenic patients are always victims of fragmented thinking, which is manifested externally through disorganized speech. The victims always have concentration problems and cannot maintain a sequence of thoughts. They answer questions haphazardly; they change from one unrelated topic to another quickly and in an unclear manner. The victim also develops phrases or words that they are the only ones who know the meaning. They also have a tendency of speaking rhyming words that are generally meaningless (Help Guide, n.d.).
Schizophrenic patients have disrupted daily activities, including personal care and interaction with other people. This mainly manifests as reduced daily functioning, inappropriate and unpredictable emotional responses, becoming uncontrollable, and developing unnecessary behaviors (Help Guide, n.d.).
This refers mainly to the lack of normal behaviors present in all normal persons. They include absolute lack of enthusiasm or interest, poor self-care, difficulties in speech, and unable to express emotions; for instance, inability to have an inexpressive face, poor eye contact, flat voice, and restricted or totally blank facial expressions (Help Guide, n.d.).
Cultural differences should be considered when looking out for schizophrenia symptoms because some symptoms associated with schizophrenia may be considered as normal behavior in some communities. For instance, seeing “visions” or hearing “voices” may be considered as religious experiences or normal visitations by a deceased member of the family in some communities, yet they are symptoms of schizophrenia. Cultures that are sociocentric also have fewer cases of schizophrenia, compared to egocentric cultures (Banerjee, 2012).
Frequently Used Treatment Modalities
Treatment strategies involve either Cognitive Behavioral Therapy (CBT) or administration of drugs. However, a combination of the two has proven very successful and effective. Psychological therapy involves interventions such as cognitive remediation, assertive community development, family therapy, skills training, and psychosocial measures to help the patient manage the use of drug substances and weight (Psychiatric Online, n.d.).
The actual cause of schizophrenia is not known, thus the medicines administered are mainly meant to deal with the symptoms. The victims are always given antipsychotics as a first line of defense against schizophrenic symptoms. The most commonly used antipsychotics include Clozapine, Fluphenazine, Haloperidol, Perphenazine, and Chlorpromazine (Psychiatric Online, n.d.).
Potential Adverse Effect Following Treatment
Several side effects may develop following administration of antipsychotics. The most common side effects that are experienced include blurred vision, drowsiness, skin rashes, dizziness, raised heartbeat, increased sensitivity towards the sun, and menstrual complications in women. Atypical medication with antipsychotics can make one gain a lot of weight and create complications in metabolism; this predisposes one to other secondary and deadly diseases such as diabetes. Other side effects are related to physical deformities, such as recurrent muscle spasms, rigidity, restlessness, and tremors (Psychiatric Online, n.d.).
Goals of Treatment
Treatment goals are guided by the state of the affected individual and may be long term or short term. Some of the goals of treatment include reducing or totally eliminating the symptoms, preventing re-occurrence of relapses, preventing or reducing the need for hospitalization, helping the patient to avoid experiencing side effects that may result from taking medication, and effectively reducing or eliminating the suffering so that the victim can have a positive thinking about life once again. The ultimate goal in all interventions is to help the victim regain the normal life and resume daily activities, just as normal persons.
Other goals include preventing harm that may occur due to the patient’s aggressiveness, bring the weird behavior under control, reduce or eliminate the severity associated with psychosis and related symptoms, effect a formula that will ensure a rapid return to normal functioning, and link the affected patient with aftercare that is most appropriate within the community (American Psychiatric Association, n.d.).
Effect on Schizophrenia on a Victim Life
Schizophrenia impacts negatively on the life of the affected victim. Apart from the financial burden the disease levies on the diseased and family, the condition also predisposes one to other diseases. The use of medication may increase the risk of developing obesity as it results in excessive weight gain. Occurrence of multiple diseases eventually reduces the lifespan of the victim significantly. Schizophrenia has also been identified as a major cause of disability. Furthermore, these victims end up being heavy smokers, smoking cigarette with high levels of nicotine. The later effect is development of lung cancer and related diseases and eventually death. Apart from the health effects, the victims also suffer from psychological torture, loneliness, and rejection. They persistently live in fear and experience a poor quality lifestyle.
American Psychiatric Association (n.d.). Treating Schizophrenia: A quick reference guide. Web.
Banerjee, A. (2012). Cross-cultural variance of schizophrenia in symptoms, diagnosis and treatment. Georgetown University Journal of Health Sciences, 6(2), 18-24. Web.
Help Guide (n.d.). Understanding Schizophrenia. Web.
Psychiatric Online (n.d.). Practice guidelines for the treatment of patients with Schizophrenia: Second edition. Web.